1. Field of the Invention
This invention relates to an electronic blood pressure monitor and a blood pressure data processing system for processing results of measurement which are obtained by electronically measuring blood pressures, and in particular, to an electronic blood pressure monitor and a blood pressure data processing system capable of assisting diagnosis and treatment of hypertension in a subject.
2. Background of the Invention
Conventionally, when a person with the authority to diagnose a patient diagnoses and treats an outpatient on the basis of blood pressure values of the patient, the blood pressure values are not necessarily considered to be reliable values since they are results of a measurement performed when the patient is at a medical facility. That is, blood pressure values are variable even within a day, as well as influenced by additional body activity due to the visit to the hospital. Also, the phenomenon of xe2x80x9cwhite-coat hypertensionxe2x80x9d is known, so-called because it is induced by the patient""s seeing a doctor wearing a white laboratory coat, so that diagnosing and treating hypertension based on blood pressure values taken when a patient is at a medical facility has been viewed with suspicion. Hence there has been a demand for a blood pressure measurement system which is useful for properly measuring blood pressures which are representative of blood pressures of the patient and for diagnosing and treating hypertension.
Conventionally, there have been a few examples of measuring blood pressures in a daily life outside a hospital, in which a patient herself/himself regularly measures blood pressures and records the result of the measurement every day and at predetermined times under the instruction of a person with the authority. In the manner as described above, however, the patient may forget the measurements to be performed at the predetermined times, or may be in a condition in which measurement is impossible, or the measurement data may not be recorded properly, and additionally, measurement of blood pressure cannot be performed when the patient is asleep. Accordingly, it has been impossible to properly measure blood pressure values throughout the daily life of the patient.
In view of the above, a portable blood pressure monitor is provided. A patient always wears a small blood pressure monitor, and by automatically measuring blood pressures every certain time, for example, every 15 minutes, variations in blood pressures over 24 hours can be ascertained. Also new clinical findings have been obtained based on the result of such measurements.
In such a portable blood pressure monitor, however, blood pressure values obtained in the measurements performed while the patient is moving lack reliability, and the patient always wears the blood pressure monitor including the sleeping time, so that the influence exerted on the daily life of the patient is significant, and stress caused by taking the measurement every 15 minutes cannot be ignored, making it difficult to continue the measurement for a long period of time.
As disclosed in Japanese Unexamined Patent Publication JP-A 8-275927 (1996), for example, a medical system has been proposed wherein communication means are provided between a patient at home and a medical facility, obtained blood pressure values and the like are transmitted to the medical facility, and thereby the contents of interview and instruction can be transmitted to the patient from a person with the authority to diagnose the patient. Alternatively, as disclosed in Japanese Unexamined Patent Publication JP-A 5-137697 (1993), a portable blood pressure monitor capable of inputting event times for blood pressure measurement, for example, such as after administration of medicine, after meals, just before going to bed, just after waking up, and capable of storing these events together with the measured blood pressure values has been proposed.
However, a data processing system for diagnosing and treating a patient having hypertension has not been proposed yet, and a system which is useful for both a patient having hypertension and a person with authority to diagnose the patient has not been proposed yet.
As described above, it is the current situation that not only does a blood pressure monitor suited for measurement at home for patients having hypertension and prospective patients having hypertension not exist, but also a tool capable of assisting diagnosis by sending information such as blood pressure measurement data, measurement time and the like to a person with the authority to diagnose the patient from the patient having hypertension and capable of judging the hypertension based on the obtained data does not exist. For this reason, it has been impossible to effectively control the blood pressure values which otherwise could be a matter of life or death, and increases in medical fees due to wasteful administration of medicine and unsuitable treatment have occurred.
Accordingly, this invention is directed to providing an electronic blood pressure monitor and a blood pressure data processing system capable of assisting diagnosis and treatment of hypertension symptoms or the like.
An electronic blood pressure monitor according to an aspect of this invention includes a measuring portion configured to measure a blood pressure of a subject and an output portion outputting data including results of the blood pressure measurement, and further may include a first input interface inputting time habit data, a second input interface inputting measurement pattern data and a timing adjustment device.
As time data indicating a time habit of the subject is inputted by the first input interface for inputting time habit data, and pattern data specifying a certain timing of a plurality of blood pressure measurements by the measuring portion is inputted by the second input interface for inputting pattern data, the timing adjustment device variably adjusts the timing of a plurality of measurements defined by the inputted pattern data based on the inputted time habit data of the subject.
Therefore, as a person with the authority to diagnose the subject inputs pattern data and designates a timing of a plurality of blood pressure measurements, the designated timing of the plurality of blood pressure measurements is variably adjusted in accordance with the time data indicating the daily habits of the subject, and the measurements are performed according to a schedule that has been so adjusted. Accordingly, blood pressure measurements can be performed according to a schedule which has been adjusted in accordance with the daily habits of the subject, with the result that more accurate measurements are achieved. By presenting such data including the results of measurements via the output portion, it is possible to provide information which is useful for assisting diagnosis and treatment of hypertension symptoms of the subject.
The electronic blood pressure monitor as described above further includes an alarming device for notifying a time of blood pressure measurement based on the timing altered by the timing adjustment device.
Therefore, since an alarm for notifying blood pressure measurement is issued for the subject every timing of blood pressure measurement, it is possible to prevent the subject from missing or forgetting the blood pressure measurement times.
In the above-described blood pressure monitor, the timing of the blood pressure measurements defined by the measurement pattern data is configured to diagnose hypertension of the subject.
Therefore, the predetermined timings for diagnosing hypertension of the subject can be variably adjusted in accordance with the daily habits of the subject, so that more correct diagnosis is realized.
The above-described blood pressure monitor further includes a first input portion providing the first input interface and a second input portion providing the second input interface, the second input portion being accessible only to a person with the authority to diagnose the subject.
Therefore, since a third party including the subject other than a person with the authority to diagnose the subject is not allowed to operate the second input portion, it is possible to securely prevent the pattern data defining the predetermined timings of blood pressure measurement inputted by external operation of the second input portion by a person with the authority to diagnose the subject from being changed by such a third party.
The above-described electronic blood pressure monitor further includes an event input interface inputting an event occurrence data into the blood pressure monitor, and the event input interface includes a first event input portion disposed on the first input portion.
Therefore, the subject can input events which occur in his or her daily life and have influence on the blood pressure measurement (for example, exercise, driving cars, meals, smoking, drinking and the like) at any time by operating the first input portion.
The above-described electronic blood pressure monitor further includes an event input interface for inputting event occurrence data into the blood pressure monitor, and the event input interface includes a second event input portion disposed on the second input portion.
Therefore, a person with the authority to diagnose the subject can input events occurring in the daily life of the subject that are determined the influential on the blood pressure measurement by operating the second event input portion.
The event occurrence data inputted by the second event input interface may be used by the blood pressure monitor to display therapeutic instructions, such as exercise, dieting or no smoking, from a person with authority to diagnose the subject, and may provide a record of administering medicine to the subject.
The computation of the above-described blood pressure monitor includes calculating a difference between the results of the measurements before and after a passage of a predetermined time from the start of administering the medicine.
Therefore, in the case of administering medicine such as an antihypertensive, it is possible to display assisting data for diagnosing the effect of the administration.
The above-described blood pressure monitor further includes a memory portion storing data including the time habit data, the measurement pattern data and the measurement data, the measurement data being stored in the memory portion chronologically.
Therefore, since a chronological change in measurement data can be confirmed by reading out the measurement data stored in the memory portion, it is possible to provide a more appropriate diagnosis.
The above-described blood pressure monitor further includes an event input interface inputting event occurrence data into the blood pressure monitor, the event occurrence data being stored in the memory portion chronologically, and an event corresponding to the event occurrence data has an influence on the blood pressure measurements.
Therefore, since a chronological change in measurement data and chronological occurrences of events in association with daily life that will influence on the blood pressure measurement are represented by reading out the measurement data stored in the memory portion, it is possible to determine a correlation between the change in measurement data and the occurrences of the events that will influence on the blood pressure measurement.
The above-described blood pressure monitor further includes a computation portion which selects a set of the measurement data stored in the memory portion based on selection criteria for hypertension diagnosis, performs a computation on the selected data based on computation criteria for hypertension diagnosis, performs a judgment on a result of the computation based on judging criteria for hypertension diagnosis, and transfers a result of the judgment to the output portion.
Therefore, in this blood pressure monitor, since a set of the measurement data is selected based on selection criteria for hypertension diagnosis, and the set of the measurement data is subjected to computation and the computation result is judged, and the judgment result is outputted, so that it is possible to provide an index for assisting the diagnosis of hypertension.
In the above-described blood pressure monitor, a readout from the memory portion is allowed only for a person with the authority to diagnose the subject. Therefore, it is possible to prevent the measurement data or the judgment data or the event data stored in the memory portion from being read out by a third party other than a person with the authority to diagnose the subject, which reduces the likelihood of invasion of privacy of the subject and the illegal falsification of stored data.
The memory portion may be detachably mounted on the blood pressure monitor. This provides convenience for the subject since the subject can bring just the memory portion to the medical facility and have a diagnosis.
In the above-described blood pressure monitor, the result of the judgment is stored in the memory portion. Therefore, by temporarily storing the above-described index for assisting the hypertension diagnosis in the memory portion and reading out the same index at a medical facility or the like, it is possible to provide information for assisting diagnosis and prescription of medication.
In the computation in the above-described electronic blood pressure monitor, the plurality of the blood pressure measurements includes a first measurement performed when the subject wakes up, a second measurement performed when the subject completes a day""s work, and a third measurement performed when the subject goes to bed, and the computation includes dividing a result of the second measurement by a result of the third measurement or an average of a result of the first measurement and the result of the third measurement.
In the computation in the above-described electronic blood pressure monitor, the plurality of the blood pressure measurements includes night-time measurements performed when the subject is asleep and day-time measurements performed when the subject is awake, and the computation includes calculating an average of results of the night-time measurements, calculating an average of results of the day-time measurements, a first day-time measurement and a last day-time measurement being excluded from the average computation, and dividing the average of the results of the day-time measurements by the average of the results of the night-time measurements.
In the computation in the above-described electronic blood pressure monitor, the plurality of the blood pressure measurements includes day-time measurements performed when the subject is awake, and the computation includes calculating an average of results of the day-time measurements, a first day-time measurement and a last day-time measurement being excluded from the average computation, calculating an average of results of the first and last day-time measurements, and dividing the average of the results of the day-time measurements by the result of the last day-time measurement or the average of the results of the first and last day-time measurements.
In the computation in the above-described electronic blood pressure monitor, the plurality of the blood pressure measurements includes night-time measurements performed when the subject is asleep and a day-time measurement performed when the subject completes a work of a day, and the computation includes calculating an average of results of the night-time measurements, and dividing the day-time measurement by the average of the results of the night-time measurements.
By the computation process as described above, an index for diagnosing the inverted dipper (night-time blood pressure is higher than day-time blood pressure or 24-hour average blood pressure), non-dipper (an increase in day-time blood pressure is slight with respect to night-time blood pressure), dipper (a decrease in night-time blood pressure is normal) or extreme dipper (the decrease is excessive) can be outputted as a result of the process.
In the computation in the above-described electronic blood pressure monitor, the plurality of the blood pressure measurements includes a first measurement performed when the subject wakes up and a second measurement performed when a predetermined time passes after the first measurement, and the computation includes dividing a result of the second measurement by a result of the first measurement.
By this computation process, it is possible to output an index for diagnosing the morning surge (rapid blood pressure rising in the early morning) as a result of the process.
In the computation in the above-described electronic blood pressure monitor, the plurality of the blood pressure measurement includes day-time measurement performed when the subject is awake, and the computation includes calculating an average of results of the day-time measurements, a first day-time measurement and a last day-time measurement being excluded from the average calculation, calculating an average of results of the first and last day-time measurements, and dividing a result of a blood pressure measurement performed on the subject when the subject is at a medical facility with the authority to diagnose the subject by the average of the results of the day-time measurements, the result of the blood pressure measurement performed at the medical facility being stored in the memory portion.
The blood pressure measurement at the medical facility is performed when a person with the authority to diagnose the subject is with the subject.
By such a computation process, it is possible to output an index for diagnosing the presence/absence of white-coat hypertension (becoming tense in front of a person with the authority (wearing a white coat, for example) to diagnose the subject to cause increase in blood pressure) as a result of the process.
The above-described electronic blood pressure monitor further includes an event input interface inputting an event occurrence data into the blood pressure monitor, the event occurrence data being stored in the memory portion chronologically, and the computation includes calculating a difference of the result of the measurements before and after an occurrence of an event specified by the event occurrence data. In this computation process, the result of the measurement after an occurrence of an event specified by the event occurrence data read out from the memory portion may be divided by the result of the measurement before the occurrence of the event specified by the event occurrence data read out from the memory portion. Alternatively, averages of the result of the measurements before and after an occurrence of an event specified by the event occurrence data read out from the memory portion may be calculated, and the average of the measurement after an occurrence of an event may be divided by the average of the measurement before an occurrence of the event.
Therefore, it is possible to ascertain the relationship between the result of the blood pressure measurement and events that influence the blood pressure measurement in association with daily life.
A blood pressure data processing system according to another aspect of this invention includes an electronic blood pressure monitor configured to measure the blood pressure of a subject and to output measurement data including a result of a blood pressure measurement and an information processing system receiving the measurement from the electronic blood pressure monitor.
The electronic blood pressure monitor includes a timing adjustment portion which receives time habit data indicative of a daily habit pattern of the subject and measurement pattern data identifying a timing of a plurality of blood pressure measurements on the subject, and alters the timing of the measurements defined by the measurement pattern data based on the time habit data of the subject, and a memory portion storing data including the measurement data.
The information processing system includes an information reception device receiving the measurement data read out from the memory portion of the electronic blood pressure monitor in response to a read request and an output device outputting the measurement data received by the information receiving device.
Therefore, at the electronic blood pressure monitor, if a person with the authority to diagnose the subject or the like designates and inputs a plurality of predetermined timings of blood pressure measurement, the designated plurality of predetermined timings are variably adjusted on the basis of the time habit data indicative of a daily habit pattern of the subject, and the blood pressure measurements are performed according to the adjusted timings, while the data including the measurement data is stored in the memory portion. Then at the information processing system of the medical facility, the data stored in the memory portion is received and outputted. Accordingly, since it is possible to perform the blood pressure measurements according to timings adjusted in accordance with the daily habit pattern of the subject, more accurate measurements are enabled. Such information including measurement data is displayed via the output device of the information processing system of a medical facility, useful information for assisting the diagnosis and treatment of the hypertension symptoms of the subject can be acquired at a medical facility.
The electronic blood pressure monitor of the above-described blood pressure data processing system further includes a computing portion performing a predetermined computation on the measurement data stored in the memory portion based on criteria of hypertension diagnosis and storing the result of the computation in the memory portion.
Therefore, at a medical facility, since the result of the predetermined process for assisting the diagnosis of hypertension of the subject based on the measurement data of blood pressure of the subject is displayed via the output device of the information processing system, it is possible to acquire information useful for assisting the diagnosis and treatment of the patient""s hypertension symptoms.
In the above-described blood pressure data processing system, the electronic blood pressure monitor further includes an information sending portion sending the measurement data in response to the read request, and the information processing system comprises an information receiving portion receiving the measurement data sent from the information sending portion.
Therefore, the measurement data of blood pressure stored in the memory portion of the electronic blood pressure monitor or the result of the predetermined process for assisting the diagnosis of hypertension based on the measurement data of blood pressure can be given to the information processing system of the medical facility by communication.
In the above-described blood pressure data processing system, the electronic blood pressure monitor may be configured to be directly connected to the information processing system by a data transmitting cable.
Furthermore, the communication may be established by connection via radio, public line network (including the Internet), dedicated line network or the like.
In the above-described blood pressure data processing system, the memory portion may include a detachable storage medium, the electronic blood pressure monitor may include a first medium access portion detachably engaging with the detachable storage medium and accessing the detachable storage medium engaged with the first medium access portion, and the information reception device may include a second medium access portion detachable engaging with the detachable storage medium and accessing the detachable storage medium engaged with the second medium access portion when the read request is inputted.
Therefore, the memory portion which stores the measurement data of blood pressure or the result of the predetermined process for assisting a diagnosis of hypertension based on the measurement data of blood pressure is advantageously a portable storage medium. Accordingly, after completing the blood pressure measurements, the subject removes the storage medium from the first medium access portion of the electronic blood pressure monitor and brings the same storage medium to the medical facility. At the medical facility, the storage medium provided by the subject is accessed via the second medium access portion of the information processing system, and the contents of the storage medium are read out to be displayed to a person with the authority to diagnose the subject.
In this manner, all the subject has to do is to go to the medical facility while carrying the storage medium for presenting the information for assisting a diagnosis of hypertension to a person with the authority to diagnose the subject and have a diagnosis (or prescription), which is convenient.
In the above-described blood pressure data processing system, the measurement data is read out only when the read request is verified.
Therefore, the measurement data of blood pressure from the memory portion or the result of the predetermined process for assisting a diagnosis of hypertension based on the measurement data of blood pressure may be accessed and read out only when the read request is verified. Therefore, it is possible to prevent the measurement data or the judgment data or the event data stored in the memory portion from being read out by a third party other than a person with the authority to diagnose the subject, which reduces the likelihood of invasion of privacy of the subject and the illegal falsification of stored data.
The above-described blood pressure data processing system further may include a patient record registry device for registering a patient record and a patient record management device for managing the patient record. The electronic blood pressure monitor further may include an information sending portion sending the measurement data read out from the memory portion. The patient record management device receives the measurement data sent from the information sending portion and stores the measurement data in the patient record registry device as a part of the patient record, and the information processing system receives a patient record of the subject stored in the patient record registry through the patient record management device and performs a predetermined computation on the measurement data based on criteria on hypertension diagnosis and patient record of the subject.
Therefore, information including the measurement data of blood pressure of the subject stored in the memory portion of the electronic blood pressure monitor is sent to be received by the patient record management device of the medical facility. The patient record management device registers the received information as patient record data in the patient record registry for each subject, and the information processing system reads out the patient record of the subject registered in the patient record registry and performs a predetermined process for assisting a diagnosis to output a result of the process.
Therefore, the subject may have a diagnosis (prescription) even at home by being subjected to the predetermined process by the medical facility for assisting a diagnosis based on the information including the measurement data of blood pressure of the subject.
In the above-described blood pressure data processing system, the blood pressure monitor is allowed to send the measurement data to the patient record management device only when the patient record management device verifies the blood pressure monitor.
Therefore, since the electronic blood pressure monitor is allowed to send the information including the measurement data of blood pressure of the subject to the data management device from the electronic blood pressure monitor by means of the information sending potion only when the blood pressure monitor is verified, it is possible to prevent the patient record data in the patient record registry from being interfered with by information sent from an illegal apparatus.
In the above-described blood pressure data processing system, the blood pressure monitor is connected to the patient record management device via a communication network and a network connection device.
In the above-described blood pressure data processing system, the network connection device may be a mobile communication terminal.